One of the stereotypical archetypes of the advanced-age set is an older man or woman sitting at a table littered with orange pill containers, confused and worried half to death about utilizing the correct timing and dosage for myriad medications. Unfortunately, I’ve seen this far too many times during my career in geriatric care.
This situation is a prime example of what is often-times referred to as “Polypharmacy.” This is essentially a fancy name for the use of many different drugs, generally prescribed by multiple physicians, for patients suffering from one or more health maladies.
Here’s another fifty-cent medical term – the notion of a “Prescribing Cascade.” Essentially, this unfortunate phenomenon occurs when an older patient suffers side effects from one medication that are mistakenly diagnosed as an additional health issue… which often leads to the prescription of an additional drug, increasing the likelihood of continued side effects. I term it “The Treadmill Effect.”
Both of these serious issues aren’t just in the domain of the elderly, but there’s little doubt that older individuals are the ones most affected by the use of multiple medications. CBSNews.com reports that in the last decade, the percentage of people over the age of 60 who take five or more medications has grown from 22 to 37% percent. Moreover, some 30 million Americans take five or more drugs for one particular medical condition.
Another interesting stat worthy of mention is that folks who are 65 or older comprise 13 percent of the population but utilize about 30 percent of all prescriptions that are written. And when you throw in supplements and over-the-counter medications, the scenario can potentially become even more unsettling.
There are some who are able to handle this situation with little or no problem, but in many cases, patients consuming a variety of medications find themselves at great risk for drug-related problems.
There’s no easy answer for some of the unpleasant aspects of Polypharmacy in the elderly, but patients can make an important first step by getting on the same page with all of their physicians and pharmacies. Make sure all of your doctors are well aware of all the prescriptions you or a loved-one is taking to ensure that one drug isn’t making it necessary to take another drug.
Patients or loved ones must take personal responsibility. Physicians are ultimately responsible for the well-being of many patients, but the onus is on the individual/caregiver to take a good, hard look at the medicines and ask as many questions of your physician or pharmacist as is necessary. In regards to eradicating the ill effects of Polypharmacy and/or a “Prescribing Cascade,” as the cliché goes via healthcare: Questions are the answer.